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    A Case of Syphilitic Chancre of The Tongue

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    Initial presentation of syphilis may be the oral cavity. Because oral lesions are highly contagious, it is vital to make correct diagnosis and start therapy because interrupt chain of infection.

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    A Case of Syphilitic Chancre of The Tongue

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    Scivision Publishers
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    Initial presentation of syphilis may be the oral cavity. Because oral lesions are highly contagious, it is vital to make correct diagnosis and start therapy because interrupt chain of infection.

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    A Case of Syphilitic Chancre of the Tongue

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    Initial presentation of syphilis may be the oral cavity. Because oral lesions are highly contagious, it is vital to make correct diagnosis and start therapy because interrupt chain of infection.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    6 views3 pages

    A Case of Syphilitic Chancre of The Tongue

    Uploaded by

    Scivision Publishers
    Initial presentation of syphilis may be the oral cavity. Because oral lesions are highly contagious, it is vital to make correct diagnosis and start therapy because interrupt chain of infection.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    Case Report ISSN: 2690-537X

    Research Article Dermatology Research

    A Case of Syphilitic Chancre of the Tongue


    Galdava G1,2, Liluashvili S1,3* and Kvirkvelia V1

    LTD “KANVENI – S/R National Center of Dermatology and


    1
    *
    Correspondence:
    Venereology” Tbilisi, Georgia. Liluashvili S, LTD “KANVENI – S/R National Center of
    Dermatology and Venereology” Tbilisi, Georgia, Kartozia str.8,
    Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia.
    2
    Tbilisi. Tel: (+995)551 51-23-40.
    European University, Tbilisi, Georgia.
    3
    Received: 11 July 2021; Accepted: 03 August 2021

    Citation: Galdava G, Liluashvili S, Kvirkvelia V. A Case of Syphilitic Chancre of the Tongue. Dermatol Res. 2021; 3(2): 1-3.

    ABSTRACT
    Initial presentation of syphilis may be the oral cavity. Because oral lesions are highly contagious, it is vital to make
    correct diagnosis and start therapy because interrupt chain of infection. In this article, we report a case of primary
    syphilis with extra genital chancre on the tongue.

    Keywords and edges, therefore, may impose difficulties in diagnosis and


    Syphilis, Tongue, Oral ulcer. detection. In this article, we report a case of primary syphilis with
    extra genital chancre on the tongue observed in a patient with a
    Introduction history of unprotected urogenital sex. The patient was treated in
    Syphilis is sexually transmitted infectious disease caused by our clinic.
    Treponema pallidum, which is a spirochete bacterium. Due to its
    many protean clinical manifestations, it has been named the “great Case Presentation
    imitator and mimicker” [1,2]. A 23-years–old bisexual man with a history of unprotected
    orogenital contact came to our clinic for the presence of an
    Syphilis is transmitted sexually from person to person, either by asymptomatic ulcerative lesion over the tongue (Figure 1). It
    direct contact with syphilis ulcers or by infected blood through was noted that the patient had previously consulted his family
    micro traumas during sexual intercourse. Syphilis may also be physician and dentist at another clinic with the same complaint. He
    transmitted by the transfusion of blood and blood components. was pre-diagnosed with herpes, and subjected to both systematic,
    Lastly, the fetus in the uterus before birth and develop into chronic and topical antiviral treatments during 10 days, without any
    infections disease may acquire syphilis: Congenital Syphilis. results. Clinical examination revealed an isolated indurated
    Syphilis remains a major public health problem with increasing two reddish 2- and 2,5-cm asymptomatic ulcer accompanied by
    incidence worldwide. It can be divided into primary syphilis, lymphadenopathy. The ulceration was deep, with a red base and
    secondary syphilis, latent syphilis, and tertiary syphilis [3]. The an irregular raised border. Extra oral clinical examination revealed
    chancre seen at the primary stage is classically a painless erosion a 3-cm nodule in the upper neck region that was asymptomatic and
    overlying a firm papule, which emerges in genital areas in more mobile. No other lesions were present. Both, serological tests and
    than 90% of the patients. Primary syphilis of the mouth manifests the cytology for oral herpes were negative. The clinical features
    as a solitary ulcer usually of the lip or tongue. There are several and history suggested the possibility of an extra genital syphilitic
    case reports about unspecific manifestation of syphilis in the oral chancre. He was referred for serologic reactive rapid plasma
    cavity [4-9]. The ulceration of primary syphilis may be confused reagin (RPR) test, which turned to be positive at a titer of 1: 64.
    with traumatic ulceration, Squamous cell carcinoma or herpes T. pallidum hem agglutination test (TPHA) was reactive with the
    simplex [10] However, extra genital chancres may differ from titer of 1:80. Moreover, dark field microscopic examination of the
    classic ones in terms of localization, amounts, size, depth, base, ulcer swab confirmed, that the patient was positive for T. pallidum.

    Dermatol Res, 2021 Volume 3 | Issue 2 | 1 of 3


    Patient was treated with intramuscular benzathine penicillin 2.4 pregnancy. Another potential route of transmission is needle
    million units. He experienced moderate chills and rigors in the sharing [11].
    first 24 h after the treatment, indicating to the Jarish-Herxheimer
    reaction. Physical examination after one week revealed that the Several different dermatological lesions, involving both the skin
    oral lesion was significantly reduced (Figure 2). After three months and mucous membranes, characterize syphilis. During the primary
    of treatment, patient had negative RPR test result. stage of syphilis, the painless ulcers develop, which occur at the
    site of Treponema pallidum inoculation – mostly in the genital
    areas. Syphilitic chancres have been described on almost any
    site of the body exposed to the infection: anus, oral cavity, lips,
    pharyngeal, and nipple - areola [12]. At least 5% of syphilitic
    chancres are extra genital and the oral mucosa is the most frequently
    exposed site, because of unprotected urogenital contact, wrongly
    considered as a safe sex practice [13]. Extra genital chancres are
    often misdiagnosed due to lack of consideration as STIs, since
    lesions do not involve genitalia [14]. We could speculate that the
    real incidence of extra genital syphilitic chancres is higher than
    the 5% reported in the literature and would like to point to the
    necessity for the clinicians to maintain a high index of suspicion.

    The therapies for both genital and extra genital syphilitic chancres
    are identical: for primary syphilis CDC, guideline recommends
    the use of Benzathine penicillin G 2.4 million units once
    intramuscularly [15].

    In conclusion, we strongly recommend that all asymptomatic


    indurated ulcerative lesions that appear and spread at any location
    on the body to be investigated with suspicion of primary syphilis.
    Figure 1: Initial extra genital chancre of the tongue.
    References
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    of syphilis is true? J Sex Med. 2014; 11: 3112-3118.
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    Dermatol Res, 2021 Volume 3 | Issue 2 | 2 of 3


    9. Rodrigo-Soares de Andrade, Edimilson-Martins de Freitas, 12. Allison SD. Extragenital syphilitic chancres. J Am Acad
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    © 2021 Galdava G, et al. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License

    Dermatol Res, 2021 Volume 3 | Issue 2 | 3 of 3

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